Drug and alcohol dependence · 2026
Substance use disorders and related hospitalizations and mortality among gay, bisexual, and other men who have sex with men: A matched cohort study.
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Aguilera-Mijares Santiago, Wang Lu, Trigg Jason, Hogg Robert S, Lachowsky Nathan, Gormezano Aki, Sereda Paul, Card Kiffer, Oviedo-Joekes Eugenia, Emerson Scott D, Lal Allan, Budu Michael, Hart Trevor A, Cox Joseph, Grace Daniel, Tan Darrell H S, Moore David M
Аннотация
BACKGROUND: Gay, bisexual, and other men who have sex with men (GBM), especially those living with HIV, may face greater substance-related harms. We compared substance use disorder (SUD) diagnoses, SUD-related hospitalizations, and all-cause mortality between GBM and men from the general population in Metro Vancouver. We also explored factors associated with these outcomes among GBM.
METHODS: We linked 798 consenting participants from two GBM cohorts (Momentum and Engage) to administrative health data and matched them (1:5) on age, sex, and geography to 3990 HIV-negative British Columbia residents. We calculated incidence rate ratios [IRR] for the three outcomes. We used multivariable regression to examine factors associated with SUD diagnoses and SUD-related hospitalizations among GBM.
RESULTS: Compared to men from the general population, GBM had higher rates of SUD diagnoses (IRR=2.73; 95% confidence interval [CI]=2.00-3.73) and SUD-related hospitalizations (IRR=1.97; 95% CI=1.21-3.20), but similar all-cause mortality (IRR=1.03; 95% CI=0.55-1.91). Substance-related deaths were rare (n = 7; all in the matches). Among GBM, SUD diagnoses were associated positively with living with HIV (adjusted IRR [aIRR]=2.95; 95% CI=1.68, 5.17) and recent transactional sex (aIRR=3.71; 95% CI=1.88, 7.33), and negatively with stable housing (aIRR=0.41; 95% CI=0.19, 0.91). SUD-related hospitalizations were associated positively with living with HIV (aIRR=3.10; 95% CI=1.46, 6.56) and recent tobacco use (aIRR=2.42; 95% CI=1.40, 4.17), and negatively with current employment (IRR=0.49; 95% CI=0.26, 0.91) and stable housing (aIRR=0.35; 95% CI=0.20, 0.64).
CONCLUSIONS: GBM experienced higher rates of SUD diagnoses and SUD-related hospitalizations. Public health and mental health interventions and policies should respond to GBM's challenges.
METHODS: We linked 798 consenting participants from two GBM cohorts (Momentum and Engage) to administrative health data and matched them (1:5) on age, sex, and geography to 3990 HIV-negative British Columbia residents. We calculated incidence rate ratios [IRR] for the three outcomes. We used multivariable regression to examine factors associated with SUD diagnoses and SUD-related hospitalizations among GBM.
RESULTS: Compared to men from the general population, GBM had higher rates of SUD diagnoses (IRR=2.73; 95% confidence interval [CI]=2.00-3.73) and SUD-related hospitalizations (IRR=1.97; 95% CI=1.21-3.20), but similar all-cause mortality (IRR=1.03; 95% CI=0.55-1.91). Substance-related deaths were rare (n = 7; all in the matches). Among GBM, SUD diagnoses were associated positively with living with HIV (adjusted IRR [aIRR]=2.95; 95% CI=1.68, 5.17) and recent transactional sex (aIRR=3.71; 95% CI=1.88, 7.33), and negatively with stable housing (aIRR=0.41; 95% CI=0.19, 0.91). SUD-related hospitalizations were associated positively with living with HIV (aIRR=3.10; 95% CI=1.46, 6.56) and recent tobacco use (aIRR=2.42; 95% CI=1.40, 4.17), and negatively with current employment (IRR=0.49; 95% CI=0.26, 0.91) and stable housing (aIRR=0.35; 95% CI=0.20, 0.64).
CONCLUSIONS: GBM experienced higher rates of SUD diagnoses and SUD-related hospitalizations. Public health and mental health interventions and policies should respond to GBM's challenges.